Provider Demographics
NPI:1255489019
Name:AHMED, MASOOD (M D)
Entity Type:Individual
Prefix:DR
First Name:MASOOD
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5356 REYNOLDS ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6016
Mailing Address - Country:US
Mailing Address - Phone:912-349-7169
Mailing Address - Fax:912-349-1202
Practice Address - Street 1:5356 REYNOLDS STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6016
Practice Address - Country:US
Practice Address - Phone:912-349-7169
Practice Address - Fax:912-349-1202
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031689207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000397449EMedicaid
GAF13261Medicare UPIN